| NPI | 1740364637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 51544) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 35450) |
| 207L00000X Anesthesiology (Licence: KY TP439) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2019-05-23 |