| NPI | 1255319398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 88860) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2006-00317) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2023-05-26 |