| NPI | 1801909411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 52265) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101239603) |
| 207L00000X Anesthesiology (Licence: VA 0101239603) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2016-09-09 |