| NPI | 1073599437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 15513) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 24414) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2016-11-03 |