| NPI | 1902174766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 282487) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 282487) |
| 183500000X Pharmacist (Licence: TX 50033) | |
| 207L00000X Anesthesiology (Licence: WA ML60558709) | |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2023-12-08 |