| NPI | 1982744371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101255233) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 47691) |
| 207L00000X Anesthesiology (Licence: CA A 127174) | |
| 207L00000X Anesthesiology (Licence: NC 2013-02009) | |
| 207L00000X Anesthesiology (Licence: PA MD437806) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2021-05-28 |