| NPI | 1215995170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N5217) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: VA 0101235523) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2022-03-29 |