| NPI | 1508258351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 65674) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301504769) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2022-07-20 |