| NPI | 1053495762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 41886) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME55270) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-10-29 |