| NPI | 1093980971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME128019) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 30734) |
| 207L00000X Anesthesiology (Licence: TX Q3879) | |
| 207L00000X Anesthesiology (Licence: MO 2012011141) | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2016-08-17 |