| NPI | 1538109939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 137453) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-0008132) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-12-31 |