| NPI | 1285633149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101237846) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC 32919) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2013-11-21 |