| NPI | 1891223988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA R-10946) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR DO204369) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2021-05-18 |