| NPI | 1376502120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 49287) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME70972) |
| 207L00000X Anesthesiology (Licence: LA MD.09211R) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2021-02-04 |