| NPI | 1932729076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 1.078105) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 61986) |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2026-07-02 |