| NPI | 1871522342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 35730) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 45190) |
| 207L00000X Anesthesiology (Licence: IL 036.091843) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2017-03-08 |