| NPI | 1033163134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD034095E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 41621) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2019-11-05 |