| NPI | 1407929607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101048275) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD 032725) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2011-11-15 |