| NPI | 1821217746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 67242) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 0420011774) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-04-01 |