| NPI | 1760616809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101273585) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC md040770) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2025-07-25 |