| NPI | 1083844187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 14625) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT195796) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2018-08-02 |