| NPI | 1760972681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL FW9028730) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 313787) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2023-03-28 |