| NPI | 1205520483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 9865) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-12850) |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2024-08-04 |