| NPI | 1588605679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 02884) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 2912) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-05-18 |