| NPI | 1518917103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 28716) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY 28716) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2013-03-01 |