| NPI | 1851719611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 72939) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301117117) |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2021-11-26 |