| NPI | 1700997905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2013-02467) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 053644) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-10-30 |