| NPI | 1639260011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.09254R) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 19165) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2025-01-13 |