| NPI | 1134577992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 85732) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 008277) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2021-08-02 |