| NPI | 1760446819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301082815) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 13978-320) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2025-12-17 |