| NPI | 1821251075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A121467) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101251612) |
| 207L00000X Anesthesiology (Licence: DC MD040381) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2012-09-06 |