| NPI | 1215905963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 66611) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 24084) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CT 66611) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OK 24084) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2020-11-05 |