| NPI | 1649376104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD441677) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 59948) |
| 207L00000X Anesthesiology (Licence: RI MD13053) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2011-08-24 |