| NPI | 1740471895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 10303) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 200943) |
| 207L00000X Anesthesiology (Licence: TX N2308) | |
| 207L00000X Anesthesiology (Licence: TN MD0000044114) | |
| 207L00000X Anesthesiology (Licence: CO 47826) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2010-11-30 |