| NPI | 1336468362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 62064) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R - 8887) |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2020-09-15 |