| NPI | 1447235189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME50248) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 26744) |
| 207L00000X Anesthesiology (Licence: AZ 22656) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-09-30 |