| NPI | 1033485719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101259616) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC MD83404) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2023-06-13 |