| NPI | 1588292379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC MMD.92139) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2023-01605) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2024-06-08 |