| NPI | 1891133765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA DO-05105) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 224353) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2024-06-26 |