| NPI | 1558495986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 44649) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08128500) |
| 207L00000X Anesthesiology (Licence: AZ 35406) | |
| 207L00000X Anesthesiology (Licence: CA A96373) | |
| 207L00000X Anesthesiology (Licence: NY 238208-1) | |
| 207L00000X Anesthesiology (Licence: WY 8281A) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2012-09-24 |