| NPI | 1861922452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA DO-05726) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-11016) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2021-09-30 |