| NPI | 1700822624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 12149) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 200200124) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2024-01-03 |