| NPI | 1356652465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 72219) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 072219) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2015-12-15 |