| NPI | 1780024711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60697647) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 278231) |
| 207L00000X Anesthesiology (Licence: CT 64240) | |
| 207L00000X Anesthesiology (Licence: WI 62826-20) | |
| 207L00000X Anesthesiology (Licence: CA A171429) | |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2021-04-18 |