| NPI | 1144292111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ID M-9858) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 46799) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2011-10-04 |