| NPI | 1689051989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301502684) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10053428) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2020-10-15 |