| NPI | 1255301479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME 018151) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 48067) |
| 207L00000X Anesthesiology (Licence: AZ 35292) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2015-03-27 |