| NPI | 1124291331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL MD.31654) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R1799) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2012-11-22 |