| NPI | 1699865287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA G64579) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 18396-875) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: UT 365543-1205) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-02-25 |