| NPI | 1689656878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 87134) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-30926) |
| 207L00000X Anesthesiology (Licence: FL ME138033) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2026-02-03 |