| NPI | 1194211722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 75506) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT216847) |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2023-01-20 |