| NPI | 1184642365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2006-00406) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 20432) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-05-20 |