| NPI | 1063505501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0042803) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 27560) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2013-10-04 |