| NPI | 1831454974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60847715) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM RS2C14-C279) |
| 207L00000X Anesthesiology (Licence: FL ME131449) | |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2019-07-22 |