| NPI | 1285612002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-48046) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-26919) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2020-12-23 |