| NPI | 1902283443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 149440) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R74956) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2021-12-06 |