| NPI | 1689036667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 83992) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 056601) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2020-07-21 |