| NPI | 1568938868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA SP-0329) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 277786) |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2026-04-16 |