| NPI | 1457402513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC MD 35071) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR-47979) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2013-07-09 |