| NPI | 1710325964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 135536) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC LL35739) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2018-08-06 |