| NPI | 1316328552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD201870) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 65271) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2021-10-26 |