| NPI | 1306889332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 16461) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2002019244) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-02-21 |