| NPI | 1639492705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 17608) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 55345) |
| 207L00000X Anesthesiology (Licence: NE 26685) | |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2022-07-21 |