| NPI | 1083119234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 1015361) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 69306) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2023-11-28 |