| NPI | 1922531094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101265704) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101265704) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2021-07-06 |