| NPI | 1265660757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301092321) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 12580) |
| 207L00000X Anesthesiology (Licence: WI 3261) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2023-07-28 |