| NPI | 1871715367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 43504) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT187118) |
| 207L00000X Anesthesiology (Licence: OR MD29091) | |
| 207L00000X Anesthesiology (Licence: TX R4066) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2019-11-13 |