| NPI | 1619261310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VA 0101260877) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101260877) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD P26492) | |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2020-10-09 |