| NPI | 1093800104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN TN 25110) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 37373) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-08-29 |