| NPI | 1871956235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS021334) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101025566) |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2023-06-22 |