| NPI | 1700096518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS11489) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101016448) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-03-11 |