| NPI | 1356301501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0059966) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101226834) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2007-07-08 |