| NPI | 1629465257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ID M-15617) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 19770) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2022-06-02 |