| NPI | 1174637003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN MD20995) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 040424) |
| 207L00000X Anesthesiology (Licence: OH 35.053100) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2016-11-10 |