| NPI | 1528320454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 269628) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC MD34894) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 269628) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2022-07-21 |