| NPI | 1578658944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101238008) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 200401534) |
| 207L00000X Anesthesiology (Licence: SC 019788) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2026-08-25 |