| NPI | 1891353454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102206464) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102206464) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2023-08-10 |