| NPI | 1790856839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 11097) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 46262-020) |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2022-07-06 |