| NPI | 1538135199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 53040) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM 2001-252) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2020-10-15 |