| NPI | 1114954849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 32376) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD.021224) |
| 174400000X Specialist (Licence: LA 021224) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2023-12-28 |