| NPI | 1366853384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2022009168) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD 259789) |
| 207L00000X Anesthesiology (Licence: NE 1805) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2022-09-23 |