| NPI | 1902847684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM 85-274) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD17520) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2024-05-09 |