| NPI | 1265483432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD205270) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 9401137) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2018-04-03 |