| NPI | 1114339728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 84420) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS017860) |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2022-05-05 |