| NPI | 1396701363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101263045) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 054134) |
| 207L00000X Anesthesiology (Licence: TN 40951) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2019-02-01 |