| NPI | 1629058920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 34656) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 46109) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2019-04-09 |