| NPI | 1972121382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS024053) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OT020366) |
| Enumeration Date | 2020-07-12 |
| Last Update Date | 2024-09-18 |