| NPI | 1366860983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 71905) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2023-00177) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-05-02 |