| NPI | 1790767945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 38130) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DE C10007270) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2019-05-20 |