| NPI | 1619149580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 82013) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ MD44131) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2022-12-08 |