| NPI | 1356634364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 64074-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-9145) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2021-06-14 |