| NPI | 1427317973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 3107) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 03725) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2016-10-19 |