| NPI | 1639191612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 060309) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 22326) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-08-10 |