| NPI | 1649241340 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 30459) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-15591) | 
| Enumeration Date | 2006-01-30 | 
| Last Update Date | 2022-09-19 |