| NPI | 1679776249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101262123) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0071853) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2017-05-01 |