| NPI | 1477797199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2018-00309) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101253832) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2021-03-16 |