| NPI | 1114977741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 204562) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 23403) |
| 207L00000X Anesthesiology (Licence: FL ME86775) | |
| 207L00000X Anesthesiology (Licence: OH 6-2149) | |
| 207L00000X Anesthesiology (Licence: PA MD-065560-L) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2007-07-08 |