| NPI | 1205810603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 00024697) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101246075) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2024-01-20 |