| NPI | 1811558620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2019023485) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2019022495) |
| Enumeration Date | 2019-06-23 |
| Last Update Date | 2023-05-22 |