| NPI | 1447511936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 52559) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 29273) |
| 208D00000X General Practice (Licence: AZ 52559) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2021-05-10 |