| NPI | 1114961000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC MD28395) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 057137) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-03-12 |