| NPI | 1356559272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102202818) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS013639) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2011-07-13 |