| NPI | 1871723254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 56955-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: ZZ 49925-P) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2022-03-31 |