| NPI | 1801475058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101285292) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 289091) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2026-07-23 |