| NPI | 1609118322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 61887) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 28382) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2025-03-14 |