| NPI | 1063455376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 66698) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 49520) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2020-09-16 |