| NPI | 1982067831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY 04786) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R4097) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2021-06-14 |