| NPI | 1023006749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 041079) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 041079) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2013-10-03 |