| NPI | 1013025535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 16232) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 24054) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2010-02-19 |