| NPI | 1558641241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA SP-212) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R9061) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2012-05-30 |