| NPI | 1629204078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 54241) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD436211) |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2023-10-09 |