| NPI | 1922391846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2015011042) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2015011042) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2016-11-15 |