| NPI | 1508806126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 243763) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2004-00306) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-05-13 |