| NPI | 1578022331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101028208) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS21008) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2026-07-21 |