| NPI | 1770972176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD H95932) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 1511) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2024-01-10 |