| NPI | 1497067326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 22770) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 25494) |
| 207L00000X Anesthesiology (Licence: AL DO-93) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2019-01-30 |