| NPI | 1710272133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 73107) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-9254) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2026-04-21 |