| NPI | 1962600270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 45574) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WY 15394C) |
| Enumeration Date | 2007-07-07 |
| Last Update Date | 2024-05-10 |