| NPI | 1306947569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ID M7113) |
| Additional Taxonomies | 174400000X Specialist (Licence: ID M7113) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2017-12-11 |