| NPI | 1568467413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 016201) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: LA 016201) |
| 202K00000X Phlebology (Licence: FL ME92186) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2017-04-24 |