| NPI | 1336103597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042-0011332) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX J1515) |
| 207L00000X Anesthesiology (Licence: MD D47351) | |
| 207L00000X Anesthesiology (Licence: VA 0101232008) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2014-05-22 |