| NPI | 1225057334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 101044440) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD462739) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2019-10-09 |