| NPI | 1467418632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 0020032) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 13983) |
| 207L00000X Anesthesiology (Licence: LA MD.016283) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2011-04-28 |