| NPI | 1467983908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY 55219) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R4611) |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2022-06-10 |