| NPI | 1669901740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 271758) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 71186) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2022-07-06 |