| NPI | 1962080002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 012047) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 06222) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2026-07-27 |