| NPI | 1194067918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2019-0080) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301102828) |
| 207L00000X Anesthesiology (Licence: DC MD044849) | |
| 207L00000X Anesthesiology (Licence: VA 0101261982) | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2020-06-04 |