| NPI | 1699753160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 28622) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101054441) |
| 207L00000X Anesthesiology (Licence: SC 28622) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2015-01-30 |