| NPI | 1063483808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 43224) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI 11700) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2012-03-28 |