| NPI | 1083815112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 83661) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 22692) |
| 207L00000X Anesthesiology (Licence: TN 47263) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2024-12-03 |