| NPI | 1609160878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 29279) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 8437523-1205) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2022-07-21 |