| NPI | 1437258159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 048451) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 245623) |
| 207L00000X Anesthesiology (Licence: NH 14376) | |
| 207L00000X Anesthesiology (Licence: MO 2005036199) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2021-04-17 |