| NPI | 1366404451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 32247) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 32247) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2011-04-18 |