| NPI | 1134357718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 49937) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 003704) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2013-08-29 |