| NPI | 1972132900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 111712) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1019969) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-09-24 |