| NPI | 1508212549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A167443) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 9408899) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2021-12-20 |