| NPI | 1073832929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301097411) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 4713-320) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2024-08-21 |