| NPI | 1346243201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 200301065) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 40306) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2017-04-27 |