| NPI | 1780813865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV DO1641) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101018432) |
| 207L00000X Anesthesiology (Licence: FL OS12336) | |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2019-05-16 |