| NPI | 1699095554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101256551) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2012-01421) |
| 207L00000X Anesthesiology (Licence: NC 164525) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2026-03-13 |