| NPI | 1073597266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD421749) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2007010594) |
| 207L00000X Anesthesiology (Licence: AR E-4539) | |
| 207L00000X Anesthesiology (Licence: AR E4539) | |
| 207L00000X Anesthesiology (Licence: OK 25499) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2020-01-15 |