| NPI | 1235270661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P2005) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 0000041651) |
| 207L00000X Anesthesiology (Licence: FL ME104922) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2012-06-29 |