| NPI | 1558673525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A125640) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R72252) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2016-08-04 |