| NPI | 1063893022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME MD23419) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4351036367) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2020-07-21 |