| NPI | 1235237215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME85887) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX T1252) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2012-07-25 |