| NPI | 1184640484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2014038007) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD427196) |
| 207L00000X Anesthesiology (Licence: WI 44870-20) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2022-09-02 |