| NPI | 1003137720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301108611) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 54030) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA 60474747) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301108611) | |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2023-05-10 |