| NPI | 1811307358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 007568) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 12468911-1204) |
| 207L00000X Anesthesiology (Licence: MN 108448) | |
| 207L00000X Anesthesiology (Licence: MN 59681) | |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2022-09-01 |