| NPI | 1689966772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 076097) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 390200000) |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2016-11-04 |