| NPI | 1972883833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS13328) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL UO2802) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2015-09-16 |