| NPI | 1013917855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2021-02174) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC 18449) |
| 207L00000X Anesthesiology (Licence: MO 2015019918) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2021-07-29 |