| NPI | 1790723096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 039174) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101007924) |
| 207L00000X Anesthesiology (Licence: KY 02739) | |
| 207L00000X Anesthesiology (Licence: AL DO-87) | |
| 207L00000X Anesthesiology (Licence: MS 14170) | |
| 207L00000X Anesthesiology (Licence: TN D.O.-632) | |
| 207L00000X Anesthesiology (Licence: AR E0202) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2018-03-17 |