| NPI | 1356609127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 301690) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R2898) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2016-09-15 |