| NPI | 1164798484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: LA 306888) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OR PG158055) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2022-07-21 |