| NPI | 1861804288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301104890) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0024101062) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2023-09-28 |