| NPI | 1205877362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME96439) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 266081) |
| 207L00000X Anesthesiology (Licence: PR 23611) | |
| 207L00000X Anesthesiology (Licence: IL 125-048327) | |
| 207LA0401X Anesthesiology Addiction Medicine (Licence: FL ME96439) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-12-17 |