| NPI | 1205215019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 91545) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD.35407) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2022-07-13 |