| NPI | 1720083827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 93362) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 100693) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2025-03-03 |