| NPI | 1205255528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102205112) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2024031393) |
| 207L00000X Anesthesiology (Licence: SC 87911) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-08-29 |