| NPI | 1912140674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 29237) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 55266-020) |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2016-05-13 |