| NPI | 1750589214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY TP221) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101244049) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VA 0101244049) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2022-11-09 |