| NPI | 1104445089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS21293) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5151014365) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2024-09-28 |