| NPI | 1891040937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 125566) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 253322) |
| 207L00000X Anesthesiology (Licence: MD D0100140) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2024-04-18 |