| NPI | 1710471032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 295278) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 276689) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2023-06-08 |