| NPI | 1558346882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 6832) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0045167) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2025-09-24 |