| NPI | 1114964715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR DO27809) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 8786) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2013-09-10 |