| NPI | 1811943657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301066975) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 2330) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-09-18 |