| NPI | 1235106790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 063497) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 41121) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2015-11-30 |