| NPI | 1154594232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 2455) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS016071) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2021-04-22 |