| NPI | 1962068536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 69259) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 11885657-1205) |
| Enumeration Date | 2019-05-19 |
| Last Update Date | 2023-10-20 |