| NPI | 1114095718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME97532) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN9588) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2023-02-09 |