NPI | 1679649255 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD H67019) |
Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 222158) |
207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 225891) | |
Enumeration Date | 2006-11-27 |
Last Update Date | 2011-11-23 |