| NPI | 1821045287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ID M-9979) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 0483612) |
| 207L00000X Anesthesiology (Licence: MA 227425) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-01-06 |