| NPI | 1366659872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA DO.000173) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102201937) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2010-06-29 |