| NPI | 1275735920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD451607) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME98500) |
| 207L00000X Anesthesiology (Licence: VA 0101241138) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2017-03-22 |