| NPI | 1861741126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2019003842) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 128346) |
| Enumeration Date | 2012-09-02 |
| Last Update Date | 2023-07-13 |