| NPI | 1174978639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 23935) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 75369) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2023-08-15 |