| NPI | 1558366310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 30200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL 110838) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2021-11-01 |