| NPI | 1871866251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS13650) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL B636114803300) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2023-12-29 |