| NPI | 1265726954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 070856) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 30126) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2014-01-22 |