| NPI | 1083729719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA07971100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AK 5693) |
| 207L00000X Anesthesiology (Licence: NM MD2005-0411) | |
| 207L00000X Anesthesiology (Licence: VA 0101238520) | |
| 207L00000X Anesthesiology (Licence: AZ 34412) | |
| 207L00000X Anesthesiology (Licence: NY 235509-1) | |
| 207L00000X Anesthesiology (Licence: FL ME94752) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2021-01-17 |