| NPI | 1699822833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 55476) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 60082241) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: GA 054379) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2022-01-28 |