| NPI | 1376593624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101228936) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2019-02916) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-10-29 |