| NPI | 1922086420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2022-02534) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101235377) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101235377) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2025-01-23 |