| NPI | 1417243387 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 17077) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 248349) | 
| 207L00000X Anesthesiology (Licence: MA 248349) | |
| Enumeration Date | 2011-06-20 | 
| Last Update Date | 2015-07-08 |