| NPI | 1588653745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 40301) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 218288) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2019-12-04 |