| NPI | 1265871321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC LL35990) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 0058040) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2018-08-02 |