| NPI | 1134138746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 059852) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 22087) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2013-04-10 |