| NPI | 1104823616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 24277) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 024277) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2008-08-20 |