| NPI | 1124190103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA C172322) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY 48496) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2021-08-10 |