| NPI | 1528017084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.200494) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA md200494) |
| 207L00000X Anesthesiology (Licence: IA 36697) | |
| 207L00000X Anesthesiology (Licence: FL ME98633) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2010-02-18 |