| NPI | 1659465243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 83063) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2023047338) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2024-11-13 |