| NPI | 1487068144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 62763) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2017017635) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2021-03-18 |