| NPI | 1891119202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301506066) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101258679) |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2024-05-09 |