| NPI | 1063480408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD30972) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: DC MD30972) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: FL ME89394) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2024-02-20 |