| NPI | 1043522600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 68705) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 15372) |
| Enumeration Date | 2010-07-11 |
| Last Update Date | 2024-08-29 |