| NPI | 1710339809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 69466) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 267815) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CT 69466) | |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2022-05-18 |