| NPI | 1316500820 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 76995) | 
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CT 76995) | 
| Enumeration Date | 2019-04-19 | 
| Last Update Date | 2024-07-10 |