| NPI | 1982669347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101037711) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 04906) |
| 207L00000X Anesthesiology (Licence: WV 26679) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2021-03-24 |