| NPI | 1669815494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 30792) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: NY 276132) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2018-10-28 |