| NPI | 1700922838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 41056) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 65998) |
| 207L00000X Anesthesiology (Licence: WI 77830-20) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2024-10-22 |