| NPI | 1407078967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 245284) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT183993) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-08-18 |