| NPI | 1790945798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101250971) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D73440) |
| 207L00000X Anesthesiology (Licence: DC MD040240) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2015-04-28 |