| NPI | 1104112846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS13170) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL UO2800) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2022-11-04 |