| NPI | 1699843540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301103253) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 10161) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2026-06-03 |