| NPI | 1811030224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301108484) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 234426) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2025-07-28 |