| NPI | 1235110891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 062398) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD27523) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2013-06-04 |