| NPI | 1336178730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M3800) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX M3800) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2014-03-19 |