| NPI | 1912262262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SD 9922) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 6904) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2019-10-30 |