| NPI | 1497765143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 39601) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 28763) |
| 207L00000X Anesthesiology (Licence: MN 49054) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2021-04-02 |