| NPI | 1609215177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV DO2345) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL UO3675) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2019-03-12 |