| NPI | 1831134402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V9476) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301058871) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2025-10-20 |