| NPI | 1356751861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 274419) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 67253) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2025-05-27 |