| NPI | 1558865030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101276473) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA a165235) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-11-13 |