| NPI | 1346640448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 51428) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY TP631) |
| 207L00000X Anesthesiology (Licence: KY R3471) | |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2018-06-22 |