| NPI | 1285873414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0064755) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 4793) |
| 207L00000X Anesthesiology (Licence: WA OP 60075830) | |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2020-11-10 |