| NPI | 1568751600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 60331) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 15862) |
| 208600000X Surgery (Licence: IL 125060536) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2023-03-30 |