| NPI | 1144200387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 19387) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: AR C-6923) |
| Enumeration Date | 2006-01-21 |
| Last Update Date | 2008-09-11 |