| NPI | 1992192520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101269652) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 18330) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2024-12-30 |