| NPI | 1083729941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: MO 2006017511) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2006017511) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2015-04-26 |