| NPI | 1174510119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0061813) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD060913L) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2013-02-22 |