| NPI | 1073802039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 52999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2011019843) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2018-03-29 |