| NPI | 1770752909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 046716) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 161828) |
| 207L00000X Anesthesiology (Licence: MA 234527) | |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2022-09-13 |