| NPI | 1689667909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 10338) |
| Additional Taxonomies | 174400000X Specialist (Licence: ND 10338) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2017-05-05 |