| NPI | 1922322759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101256091) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 26735) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2021-03-24 |