| NPI | 1770560377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME103724) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX G9366) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2018-03-17 |