| NPI | 1801872486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME129629) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2012-0026) |
| 207L00000X Anesthesiology (Licence: LA MD.206687) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2021-03-18 |