| NPI | 1649615535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 79532) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 007375) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2022-10-31 |