| NPI | 1851551279 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 20961)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 6851189-1205)  | 
| 207L00000X Anesthesiology (Licence: CA A102149)  | |
| 207L00000X Anesthesiology (Licence: WY 8589A)  | |
| Enumeration Date | 2008-06-10 | 
| Last Update Date | 2023-07-25 |