| NPI | 1992764872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD11143) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0024776) |
| 207L00000X Anesthesiology (Licence: VA 0101224160) | |
| 207L00000X Anesthesiology (Licence: MI 4301034235) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2007-07-08 |