| NPI | 1477763951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 48932) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2006017500) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-11-22 |