| NPI | 1992794945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 9615) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD219202) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2025-10-09 |