| NPI | 1891995270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 0056056) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 52252) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WI 52252) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-06-15 |