| NPI | 1679559637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: LA 330414) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 330414) |
| 207L00000X Anesthesiology (Licence: OR MD215613) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA C139733) | |
| 207L00000X Anesthesiology (Licence: AL 00024903) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WI 21220) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2023-09-14 |