| NPI | 1336189539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 6387) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SD 4472) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2012-04-25 |