| NPI | 1750300174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102036962) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 3363) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-02-14 |