| NPI | 1134142359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2006-00507) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 09057) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2015-03-31 |