| NPI | 1811030695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0070972) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC MD038866) |
| 207L00000X Anesthesiology (Licence: VA 0101247880) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2016-01-07 |