| NPI | 1104899558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 26265) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO C41879) |
| 207L00000X Anesthesiology (Licence: MO 2004029832) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2014-10-27 |