| NPI | 1114138880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 62723) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 37689) |
| 207L00000X Anesthesiology (Licence: NH 13512) | |
| 207L00000X Anesthesiology (Licence: UT 7177439-1205) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2024-06-12 |