| NPI | 1063826899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS15404) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP1-0050304) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2018-07-20 |