| NPI | 1275996530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND PT16784) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 6261) |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2020-08-06 |