| NPI | 1407050230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 57373) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD0000043710) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-04-04 |