| NPI | 1730178708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102205460) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM A1272-04) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2018-11-27 |