| NPI | 1982085361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301502602) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2019015415) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2020-08-24 |