| NPI | 1699937391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2016-00028) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 003093) |
| 207L00000X Anesthesiology (Licence: TN 52247) | |
| 207L00000X Anesthesiology (Licence: GA 68287) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2019-03-29 |