| NPI | 1447453147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 11154) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 11154) |
| 207L00000X Anesthesiology (Licence: PA MD445102) | |
| 207L00000X Anesthesiology (Licence: MD D74104) | |
| 207L00000X Anesthesiology (Licence: VA 0101251963) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2012-05-31 |