| NPI | 1508851171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 38349) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 38349) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2018-05-10 |