| NPI | 1689815839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 73648) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 046928) |
| 207L00000X Anesthesiology (Licence: RI MD15917) | |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2023-10-25 |