| NPI | 1053425678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME136864) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA ML20008444) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 262171) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2018-09-06 |