| NPI | 1952440398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M9710) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 011699) |
| 207L00000X Anesthesiology (Licence: FL OS22356) | |
| 207L00000X Anesthesiology (Licence: OK 4336) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2025-12-04 |