| NPI | 1811065584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101252186) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0068100) |
| 207L00000X Anesthesiology (Licence: DC MD044841) | |
| 207L00000X Anesthesiology (Licence: ME MD17452) | |
| 207L00000X Anesthesiology (Licence: ME EC-05-170) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2021-07-23 |