| NPI | 1831504794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2025-01196) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL Os15306) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2025-07-30 |