| NPI | 1356600290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A139777) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R3082) |
| Enumeration Date | 2012-05-13 |
| Last Update Date | 2023-10-15 |