| NPI | 1689100224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD203216) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 10959185-1205) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2021-06-29 |