| NPI | 1164413217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 200400049) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 033115) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2015-06-08 |