| NPI | 1205036423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 22449) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301090752) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2014-04-03 |