| NPI | 1215366935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 270727) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 270727) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: ZZ 37987 , 30796) | |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2020-02-25 |