| NPI | 1730470329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 076342) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 173803) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2022-12-20 |