| NPI | 1982679288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 14874) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD047358L) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-10-15 |