| NPI | 1861529778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 38901) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 038901) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2026-04-15 |