| NPI | 1699112185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 19375) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NV 19375) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2026-05-26 |