| NPI | 1417906918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME151141) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC MD23231) |
| 207L00000X Anesthesiology (Licence: TX K9868) | |
| 207L00000X Anesthesiology (Licence: CO DR.0058816) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-03-22 |