| NPI | 1831187681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WY 11126A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101032736) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2021-01-28 |