| NPI | 1457490484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 64544) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2009-0525) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2022-05-25 |