| NPI | 1588048763 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 23957) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 008133) | 
| Enumeration Date | 2015-07-16 | 
| Last Update Date | 2023-10-20 |