| NPI | 1255569562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2013018940) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2013018940) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2014-12-18 |