| NPI | 1053635581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 74474) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME122467) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 74474) | |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2021-03-28 |