| NPI | 1679869804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q8604) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 10040191) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX Q8604) | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2021-11-22 |