| NPI | 1912193533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS016083) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 87573) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2024-08-09 |