| NPI | 1710177084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR DO193138) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS 9926) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2019-08-30 |