| NPI | 1033350590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD444397) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA mt193581) |
| 208600000X Surgery (Licence: PA MT193581) | |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2012-03-26 |