| NPI | 1356494405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 226541) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME94938) |
| 207L00000X Anesthesiology (Licence: TX P4663) | |
| 207L00000X Anesthesiology (Licence: CT 047523) | |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2022-05-11 |