| NPI | 1942639877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD464903) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 256857) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2019-04-04 |