| NPI | 1851612535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 57537) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME116383) |
| 207L00000X Anesthesiology (Licence: AZ 43312) | |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2022-05-11 |