| NPI | 1285866657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101247918) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 60983024) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2020-05-25 |