| NPI | 1881038784 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WI 63541) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 63541) | 
| 207L00000X Anesthesiology (Licence: GA 86349) | |
| Enumeration Date | 2013-04-22 | 
| Last Update Date | 2021-06-23 |