| NPI | 1720345549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D84034) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 54994) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2022-07-21 |