| NPI | 1699793075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 27707) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2019-02945) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2026-04-30 |