| NPI | 1932638533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT med-phys-lic-97106) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10965) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2021-06-15 |