| NPI | 1023225265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101250897) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC TL30213) |
| 207L00000X Anesthesiology (Licence: NC 2011-01978) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2014-07-25 |