| NPI | 1356443766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD017213) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 24749) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2019-02-22 |