| NPI | 1285736678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 27) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 17595) |
| 207L00000X Anesthesiology (Licence: IA 01525) | |
| 207L00000X Anesthesiology (Licence: SD 0980) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2007-07-08 |