| NPI | 1649512617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D82800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101277972) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2025-02-01 |