| NPI | 1477538155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 57767) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 52953) |
| 207L00000X Anesthesiology (Licence: CO 38727) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-12-15 |