| NPI | 1649685686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2019020526) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 7291) |
| Enumeration Date | 2014-06-28 |
| Last Update Date | 2019-06-18 |