| NPI | 1922486976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101025996) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 70856) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2022-12-06 |