| NPI | 1215091418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD 18508) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D 0038263) |
| 207L00000X Anesthesiology (Licence: VA 0101045620) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2007-07-08 |