| NPI | 1154391613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 95543) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 70115) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2023-07-12 |