| NPI | 1700953452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 15573) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD.022259) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2017-01-13 |