| NPI | 1114018462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME 010371) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-047062) |
| 207L00000X Anesthesiology (Licence: CA A00037736) | |
| 207L00000X Anesthesiology (Licence: DC MD013436) | |
| 207R00000X Internal Medicine (Licence: ME 010371) | |
| 207R00000X Internal Medicine (Licence: OH 35-047062) | |
| 207R00000X Internal Medicine (Licence: CA A00037736) | |
| 207R00000X Internal Medicine (Licence: DC MD013436) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-08 |