| NPI | 1972582567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101013374) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 1803) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2024-04-30 |