| NPI | 1215165287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 89388) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 010247950) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2025-01-07 |