| NPI | 1548266927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD26194) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 32814) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2018-10-17 |