| NPI | 1083241103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 48735) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101274302) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-05-18 |