| NPI | 1598830150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD 29103) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN 6692) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2022-02-04 |