| NPI | 1790982379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 002362) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 3534) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2022-04-20 |