| NPI | 1073041034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 337962) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 41100) |
| 208600000X Surgery (Licence: SC LL41100) | |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2023-08-27 |