| NPI | 1265964480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 336447) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT222272) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-08-09 |