| NPI | 1255869350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD218964) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301504320) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2024-04-03 |