| NPI | 1124204805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.204555) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 002836) |
| Enumeration Date | 2008-01-13 |
| Last Update Date | 2011-11-03 |