| NPI | 1639738859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2023-01660) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC LL82785) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2023-07-17 |