| NPI | 1134219462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SD 9150) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD039309E) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2014-06-26 |