| NPI | 1043244809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0057200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 231861) |
| 207L00000X Anesthesiology (Licence: FL ME90345) | |
| 207L00000X Anesthesiology (Licence: CT 61871) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2023-05-14 |