| NPI | 1821450412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY TP135) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY IP1511) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2022-07-21 |