| NPI | 1871791517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 37736) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD T2609) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2021-06-02 |