| NPI | 1457362980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101026438) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101026438) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2014-09-17 |