| NPI | 1144490004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS014781) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT010389) |
| 208600000X Surgery (Licence: MD H69369) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD H69369) | |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2015-03-25 |