| NPI | 1730157769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2021000511) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 38873) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2022-09-12 |