| NPI | 1821211665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101242161) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 20704) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2024-03-19 |