| NPI | 1205194727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-55728) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2016-0071) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2022-07-21 |