| NPI | 1871150763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2023016856) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-11498) |
| Enumeration Date | 2019-05-25 |
| Last Update Date | 2023-05-09 |