| NPI | 1760596720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PR 10010) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM 2003-0037) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-06-04 |