| NPI | 1063417103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 12790) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 012790) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2008-08-21 |