| NPI | 1255828877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 73671) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 72181-21) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2023-07-13 |