| NPI | 1467656660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 253197) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 29819) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA 60208874) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2016-03-23 |