| NPI | 1619405628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA DO-06545) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10949) |
| Enumeration Date | 2017-06-03 |
| Last Update Date | 2024-10-31 |