| NPI | 1104183441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 290758) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 50504) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2023-02-08 |