| NPI | 1063683217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0072618) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD442908) |
| 207L00000X Anesthesiology (Licence: VA 0101249934) | |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2013-07-10 |