| NPI | 1407078991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101244687) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT185427) |
| 207L00000X Anesthesiology (Licence: MD D0066950) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2024-05-30 |