| NPI | 1093078495 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 6396) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR PG158664) | 
| Enumeration Date | 2012-06-20 | 
| Last Update Date | 2016-03-20 |