| NPI | 1962586834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO R9977) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC T02084) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-03-30 |