| NPI | 1558622043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2017010066) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 29174) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2018-10-08 |