| NPI | 1881684090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD036299) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 226090) |
| 207L00000X Anesthesiology (Licence: MD D0064971) | |
| 207L00000X Anesthesiology (Licence: VA 0101240376) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2007-07-20 |