| NPI | 1396755609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L7966) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 37963) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2019-12-19 |