| NPI | 1710996210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 041315) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME68553) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-12-17 |