| NPI | 1811972565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 9956) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 30530) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2025-01-13 |