| NPI | 1780881383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 140926) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 23828) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2019-08-26 |