| NPI | 1508029729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 55077) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD156935) |
| 207L00000X Anesthesiology (Licence: PA MD447508) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2016-08-01 |