| NPI | 1174941082 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2018011955)  | 
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD H86568)  | 
| Enumeration Date | 2014-03-29 | 
| Last Update Date | 2021-03-31 |