| NPI | 1245519362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 74605) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.060179) |
| 207L00000X Anesthesiology (Licence: NE 28994) | |
| 207L00000X Anesthesiology (Licence: MI 4301108958) | |
| Enumeration Date | 2011-08-07 |
| Last Update Date | 2016-05-12 |