| NPI | 1619538873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OT020358) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.075222) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2021-06-29 |