| NPI | 1578552485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101249962) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 9800845) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2025-11-10 |