| NPI | 1053367219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AR R-4003) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR R-4003) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2011-03-23 |