| NPI | 1952357717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 11435) |
| Additional Taxonomies | 174400000X Specialist (Licence: NV 11435) |
| 207L00000X Anesthesiology (Licence: WI 13391-320) | |
| 207L00000X Anesthesiology (Licence: IA MD-54120) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2025-07-10 |