| NPI | 1114424157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS023575) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL 19403) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2024-05-03 |