| NPI | 1902986078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 5217195-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 26426) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2025-05-15 |