| NPI | 1881185742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY C3180) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301114789) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2024-12-19 |