| NPI | 1497757058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN MD42607) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-30607) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2022-03-16 |