| NPI | 1487881975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301106292) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA L-240020) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301106292) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2020-03-05 |