| NPI | 1376570465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 28764) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: NC 28764) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-12-15 |