| NPI | 1992190136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101269666) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 65370) |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2021-01-27 |