| NPI | 1366702789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 29896) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 6684) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2017-06-23 |