| NPI | 1619051539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 50975) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2005-01410) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-01-06 |