| NPI | 1356609507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2017-01400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD0000050822) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2019-03-15 |