| NPI | 1205871118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CO 24546) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 24546) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2011-02-02 |