| NPI | 1831399864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 12644) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2011009252) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2017-02-24 |