| NPI | 1144276502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 28002) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 28002) |
| 207L00000X Anesthesiology (Licence: WI 24467) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-05-11 |