| NPI | 1902973993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 050791) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO CDRH.0057872) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2024-10-03 |