| NPI | 1780734616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 82339) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2016036231) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2024-04-01 |