| NPI | 1922040807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 010597) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 010611) |
| 207L00000X Anesthesiology (Licence: IA 3692) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2025-10-23 |