| NPI | 1760611727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101261856) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 256193) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2018-03-17 |