| NPI | 1891375812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 75841) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.76031) |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2025-12-16 |