| NPI | 1396124988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 290324) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: HI 20085) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2022-01-03 |