| NPI | 1609087386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AK MEDO7115) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R7692) |
| 207L00000X Anesthesiology (Licence: MT 12009) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2022-03-18 |