| NPI | 1770533622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 180400-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME DO2949) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-01-28 |