| NPI | 1215974027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0061359) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PR 15812) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2011-04-05 |