| NPI | 1205395308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2024015928) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS19992) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2024-11-25 |