| NPI | 1528454386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2020022473) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 264375) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2020-08-07 |