| NPI | 1124240973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 21108) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2009-00422) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2011-03-15 |