| NPI | 1962067595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 8445) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD215519) |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2023-11-07 |