| NPI | 1295020162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 290033) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2016-0121) |
| Enumeration Date | 2011-06-18 |
| Last Update Date | 2021-09-28 |