| NPI | 1609911791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 072856) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 201300846) |
| 207L00000X Anesthesiology (Licence: RI MD15710) | |
| 207L00000X Anesthesiology (Licence: SC TL30231) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-01-16 |