| NPI | 1285999623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA GETP.201325) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS 825-L) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2018-04-26 |