| NPI | 1013932995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2012-00146) |
| Additional Taxonomies | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: VA 0101236838) |
| 207L00000X Anesthesiology (Licence: VA 0101236838) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2012-05-22 |