| NPI | 1457396046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.05914R) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 05914R) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2015-06-18 |