| NPI | 1225053168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD424491) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY P63895) |
| 207L00000X Anesthesiology (Licence: CA A94320) | |
| 207L00000X Anesthesiology (Licence: DE C10008487) | |
| 207L00000X Anesthesiology (Licence: MI 4301083057) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2014-03-27 |