| NPI | 1063575843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 9800744) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 98-00744) |
| 207P00000X Emergency Medicine (Licence: NC 98-00744) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2010-09-07 |