| NPI | 1699781252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 45455) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0066123) |
| 207L00000X Anesthesiology (Licence: NC 2006-00895) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2022-03-24 |