| NPI | 1346445400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2011-00615) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OT011730) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2011-04-29 |