| NPI | 1710925235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2018-0996) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 5582) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2019-02-18 |