| NPI | 1801866850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101235810) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101235810) |
| 207L00000X Anesthesiology (Licence: FL TRN11585) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VA 0101235810) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2022-09-28 |