| NPI | 1386694081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD150124) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 48635) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2018-10-10 |