| NPI | 1780699116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 50701) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 0075136) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2018-11-13 |