| NPI | 1174503940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD439330) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D68209) |
| 207L00000X Anesthesiology (Licence: VA 0101233096) | |
| 207L00000X Anesthesiology (Licence: CA A102127) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2021-06-07 |