| NPI | 1467011452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 1013986) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX V3370) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: TX V3370) | |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2024-10-08 |