| NPI | 1578069811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 30185) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 238864) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2024-04-03 |