| NPI | 1578502340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: FL ME139334) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-0009851) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-05-20 |