| NPI | 1053724104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 55694) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA L-259327) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2025-01-15 |