| NPI | 1003027202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC MD41045) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.089044) |
| 207L00000X Anesthesiology (Licence: GA 82167) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: OH 35.089044) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: SC 41045) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: GA 82167) | |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2019-03-04 |