| NPI | 1366000457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101278103) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC LL82665) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2023-11-15 |