| NPI | 1922054741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101269074) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 15160) |
| 207L00000X Anesthesiology (Licence: CO DR.0059004) | |
| 207L00000X Anesthesiology (Licence: PA MD423044) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2021-03-29 |