| NPI | 1639527765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS16962) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10519) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2020-07-09 |