| NPI | 1285621110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 39201) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 17526) |
| 207L00000X Anesthesiology (Licence: CA G136300) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2024-09-30 |