| NPI | 1497843064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 23454) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 23811) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2018-03-17 |