| NPI | 1548366180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.11730R) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 14913) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2011-12-13 |