| NPI | 1891131165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301506742) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD461206) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2022-06-27 |