| NPI | 1649664236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101268964) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D86778) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2020-05-04 |