| NPI | 1710997093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 4640-320) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD428777) |
| 207L00000X Anesthesiology (Licence: WA MD60057947) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2025-01-17 |