| NPI | 1467983114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 54997) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY IP1558) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2021-08-31 |