| NPI | 1922217918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME106751) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A107447) |
| 207L00000X Anesthesiology (Licence: PA MD431389) | |
| 207L00000X Anesthesiology (Licence: MD D0068238) | |
| 207L00000X Anesthesiology (Licence: VA 0101244495) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2012-03-06 |