| NPI | 1578768222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 44647) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME101011) |
| 207L00000X Anesthesiology (Licence: MD D69246) | |
| 207L00000X Anesthesiology (Licence: NJ 25MA08537600) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2011-10-10 |