| NPI | 1063640423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 39330) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 24080) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2016-07-27 |