| NPI | 1700816592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS14497) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA DO-07097) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2025-07-25 |