| NPI | 1033104120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 28884) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 12119) |
| 208600000X Surgery (Licence: IA R-9110) | |
| 183500000X Pharmacist (Licence: IA 21406) | |
| 207L00000X Anesthesiology (Licence: NE 6662) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2016-04-06 |