| NPI | 1811438096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 54817) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 271331) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2021-06-28 |