| 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 | 2011-11-22 |