| NPI | 1578593380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 43811) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD18110) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-11-09 |