| NPI | 1669589487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101281027) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD442311) |
| 207L00000X Anesthesiology (Licence: NY 287789) | |
| 207L00000X Anesthesiology (Licence: MD D68954) | |
| 207L00000X Anesthesiology (Licence: WA ML20007519) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2024-04-01 |