| NPI | 1174830608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A119479) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R72020) |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2014-05-30 |