| NPI | 1669682779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2010036445) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R6948) |
| 207L00000X Anesthesiology (Licence: NY P56646) | |
| 207L00000X Anesthesiology (Licence: IA 37517) | |
| 207L00000X Anesthesiology (Licence: KS 0434688) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2019-12-26 |