| NPI | 1710368691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 31684) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 7455) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2019-06-03 |