| NPI | 1336118231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 14948) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 232741) |
| 208D00000X General Practice (Licence: HI MD-13102) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2023-01-23 |