| NPI | 1245750736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 74292-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 29273) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2021-11-02 |