| NPI | 1578515250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2015019904) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO ME38791) |
| 207L00000X Anesthesiology (Licence: KS 04-38210) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2016-12-06 |