| NPI | 1811967524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 31005) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 84884-20) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2025-03-04 |