| NPI | 1962095869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 35349) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 35349) |
| Enumeration Date | 2021-02-11 |
| Last Update Date | 2025-06-09 |