| NPI | 1366715989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 27704) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 27704) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2023-08-15 |