| NPI | 1124384987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS14524) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 3019) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2019-01-02 |