| NPI | 1255330536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D31879) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC 15003) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2019-08-30 |