| NPI | 1922361815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 34899) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC LL34899) |
| Enumeration Date | 2012-06-17 |
| Last Update Date | 2016-06-20 |