| NPI | 1396715918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 9701334) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 12049) |
| 207L00000X Anesthesiology (Licence: VA 0101056347) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2007-07-08 |