| NPI | 1073772646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD442655) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC 139539) |
| Enumeration Date | 2008-06-08 |
| Last Update Date | 2012-04-12 |