| NPI | 1881674760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101238779) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101238779) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2016-11-23 |