| NPI | 1255344610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT med-phys-lic-82373) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-4888) |
| 207L00000X Anesthesiology (Licence: TX P4721) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-05-26 |