| NPI | 1144318387 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 66643) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC LL27178) | 
| 207L00000X Anesthesiology (Licence: GA 066643) | |
| Enumeration Date | 2006-10-11 | 
| Last Update Date | 2022-12-01 |