| NPI | 1770712085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 28461) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: NE 28461) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2018-03-07 |