| NPI | 1598862609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2012003212) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 7987) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-01-08 |