| NPI | 1548821952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2021014633) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2019023484) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2021-05-18 |