| NPI | 1851308639 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 53765)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 29538)  | 
| Enumeration Date | 2006-08-02 | 
| Last Update Date | 2023-11-07 |