| NPI | 1578094678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 83560) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0090850) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2024-10-17 |