| NPI | 1235589441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-47005) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10659) |
| Enumeration Date | 2016-06-18 |
| Last Update Date | 2021-09-30 |