| NPI | 1649479882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD201224) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD.201224) |
| 207L00000X Anesthesiology (Licence: MI 4301109028) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2019-09-30 |