| NPI | 1386826378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 51293) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R1064) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2011-05-25 |