| NPI | 1285821553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2019042688) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 16751) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2023-08-08 |