| NPI | 1891874715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 1084) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN DO 1523) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-11-09 |