| NPI | 1942292610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 55659-020) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2010-00086) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2021-11-18 |