| NPI | 1104806280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-43977) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2004010782) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2016-12-28 |