| NPI | 1508061177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL TRN11004) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 370770-1205) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2012-10-15 |