| NPI | 1558522276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME157661) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10029626) |
| 207L00000X Anesthesiology (Licence: CO 48693) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2022-07-25 |