| NPI | 1578538716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN MD19988) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA MD45304) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2013-09-17 |