| NPI | 1659719516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 92588) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT204001) |
| 207L00000X Anesthesiology (Licence: PA MD460867) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2022-07-05 |