| NPI | 1609029602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 55934) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY 48176) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CT 055934) | |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2023-05-18 |