| NPI | 1487880993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 21896) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA L-240754) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2021-11-29 |