| NPI | 1497960264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 20678) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OT011149) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-07-09 |