| NPI | 1578559563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD H0068754) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 3850) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2009-06-10 |