| NPI | 1013028091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-52109) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 10069) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-11-07 |