| NPI | 1437140571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101260653) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD473814) |
| 207L00000X Anesthesiology (Licence: FL ME80906) | |
| 207L00000X Anesthesiology (Licence: NC 2016-01826) | |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2023-03-03 |