| NPI | 1720286776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD166108) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 7036884-1205) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2020-01-08 |