| NPI | 1619229374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 78419) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS13809) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2022-06-28 |