| NPI | 1790882421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD19575) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0042687) |
| 207L00000X Anesthesiology (Licence: VA 0101047577) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2015-03-03 |