| NPI | 1407242944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 202102318) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101264817) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2022-10-26 |