| NPI | 1215075288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D68764) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA 12345678) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2013-02-15 |