| NPI | 1003912213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2020034383) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME113181) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2020034383) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2022-09-12 |