| NPI | 1740642974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 04920) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R4158) |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2021-06-14 |