| NPI | 1356320626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G68414) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AK 3201) |
| 207L00000X Anesthesiology (Licence: MA 77095) | |
| 207L00000X Anesthesiology (Licence: NY 189729) | |
| 207L00000X Anesthesiology (Licence: TX J3659) | |
| 207L00000X Anesthesiology (Licence: MT 7125) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2012-09-04 |