| NPI | 1073715090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ID M-10006) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AZ 76558) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2011-11-04 |