| NPI | 1275794877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 47290) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CO 2544) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2017-02-16 |