| NPI | 1023213899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 63564) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 12297) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2021-08-10 |