| NPI | 1346233111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 46536) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 30062) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2014-03-05 |