| NPI | 1588809834 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 81253) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 229594) | 
| Enumeration Date | 2008-12-15 | 
| Last Update Date | 2021-11-30 |