| NPI | 1659695088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME MD22040) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 26726) |
| 207L00000X Anesthesiology (Licence: MD D0078701) | |
| 207L00000X Anesthesiology (Licence: VA 0101256209) | |
| Enumeration Date | 2010-03-13 |
| Last Update Date | 2018-07-30 |