| NPI | 1619956125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 066870) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SD 5164) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2020-10-20 |