| NPI | 1548201197 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101239430) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 34870) | 
| 207L00000X Anesthesiology (Licence: AK 5688) | |
| 207L00000X Anesthesiology (Licence: MT 11222) | |
| 207L00000X Anesthesiology (Licence: NM MD2005-0133) | |
| Enumeration Date | 2006-06-08 | 
| Last Update Date | 2024-11-25 |