| NPI | 1972689636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 59462) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2006018414) |
| 207P00000X Emergency Medicine (Licence: MO 2006018414) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2018-04-10 |