| NPI | 1053792309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2020-01546) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 38261) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2021-04-07 |