| NPI | 1427349893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101260293) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 55354) |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2020-05-01 |