| NPI | 1043232333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 24286) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 046402) |
| 207L00000X Anesthesiology (Licence: KY 37240) | |
| 207L00000X Anesthesiology (Licence: MO 2002000491) | |
| 207L00000X Anesthesiology (Licence: GA 12345) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2015-12-02 |