| NPI | 1962609222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 005544) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 2308) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2018-06-13 |