| NPI | 1275521783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 81379) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 51956) |
| 207L00000X Anesthesiology (Licence: NC 200300202) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2022-09-28 |