| NPI | 1558402990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 4499) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 49996-021) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2013-10-16 |