| NPI | 1811293855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS017035) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA ot013659) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2020-12-14 |