| NPI | 1235332206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 12083) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN11145) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2021-01-04 |