| NPI | 1679596308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AK 4238) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2024-0890) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2026-06-10 |