| NPI | 1356602627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101257407) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 48957) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2023-07-21 |