| NPI | 1932364585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101273559) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 98856) |
| 207L00000X Anesthesiology (Licence: MD d0067836) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2025-10-07 |