| NPI | 1508080102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2008-00219) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 122459) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2021-04-06 |