| NPI | 1912134149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A121811) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 241465) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2022-07-21 |