| NPI | 1861754285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-51047) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MT MED-PHYS-LIC-51047) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2020-05-06 |