| NPI | 1457619751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CT 61885) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 17074) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2018-09-05 |