| NPI | 1568606895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 50923) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2008017207) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2013-01-10 |