| NPI | 1114123775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA a108136) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-5244) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2011-06-08 |