| NPI | 1922591296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD214193) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301115638) |
| 207L00000X Anesthesiology (Licence: MN 75098) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-06-18 |