| NPI | 1275735607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101249110) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D72358) |
| 207L00000X Anesthesiology (Licence: PA MT190806) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2021-06-28 |