| NPI | 1689634768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 27295) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME75054) |
| 207L00000X Anesthesiology (Licence: PA MD036049E) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2018-05-18 |