| NPI | 1104053032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MO 2013039276) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: MO 2013039276) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2024-04-25 |