| NPI | 1588161756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD216160) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 291150) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2024-02-06 |