| NPI | 1396733929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0027494) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA C42162) |
| 207L00000X Anesthesiology (Licence: NE 26049) | |
| 207L00000X Anesthesiology (Licence: TX G5563) | |
| 207L00000X Anesthesiology (Licence: WY 6735A) | |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2013-06-07 |