| NPI | 1902287337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 83405) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC MMD.38416.LL) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2019-06-24 |