| NPI | 1225340391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 258334) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MA 244628) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2014-05-06 |