| NPI | 1659360378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301507178) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 220476) |
| 207L00000X Anesthesiology (Licence: NC 20001214) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2022-06-17 |