| NPI | 1679990956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD217612) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-70567) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2024-02-19 |