| NPI | 1083871362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2013-00704) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MT188897) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2016-09-29 |