| NPI | 1831839562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 71502) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ R80318) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2026-06-29 |