| NPI | 1518997873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV DO1372) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 229045) |
| 207L00000X Anesthesiology (Licence: AZ 4572) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-12-29 |