| NPI | 1760554901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 19852) |
| Additional Taxonomies | 174400000X Specialist (Licence: WV 19852) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2018-03-29 |