| NPI | 1386890036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 66593) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2008016308) |
| 207L00000X Anesthesiology (Licence: TX P3476) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX P3476) | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2021-04-13 |