| NPI | 1215159025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 26145) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: GA 059142) |
| 207L00000X Anesthesiology (Licence: GA 059142) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2012-03-29 |