| NPI | 1528008562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD18872) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 15475) |
| 207L00000X Anesthesiology (Licence: OK 35038) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-04-20 |