| NPI | 1356447221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101022866) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 9381) |
| 207L00000X Anesthesiology (Licence: WI 62602) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2021-03-29 |