| NPI | 1053330571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 135335) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301058243) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-06-15 |