| NPI | 1023300936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 04047) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 006642) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2020-07-15 |