| NPI | 1053304915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101284083) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 41226) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2024-11-05 |