| NPI | 1043659246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 1297) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 1297) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2017-06-12 |