| NPI | 1063447324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101250566) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME 016167) |
| 207L00000X Anesthesiology (Licence: TX N6440) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-07-25 |