| NPI | 1083609861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 54361) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 16657) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2017-11-20 |