| NPI | 1073587747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 50208) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD072439L) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-10-01 |