| NPI | 1063855583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2024-00025) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS018557) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2024-09-17 |