| NPI | 1184604332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 3981) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO R9D77) |
| Enumeration Date | 2006-01-21 |
| Last Update Date | 2015-01-05 |