| NPI | 1598961757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WY 11791A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AK 7756) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2025-09-16 |