| NPI | 1376533182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101243404) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME155833) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 226647) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2022-09-14 |