| NPI | 1003866849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101019563) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 251679) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2022-07-21 |