| NPI | 1578595377 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 34812) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D62875) | 
| Enumeration Date | 2006-07-06 | 
| Last Update Date | 2007-07-08 |