| NPI | 1063779015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD184749) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 266820) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2023-11-20 |