| NPI | 1245243047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 15334R) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 19343) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2013-02-21 |