| NPI | 1861953002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 76176) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1013106) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2024-09-15 |