| NPI | 1578653143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101245799) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR R-4501) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2009-09-10 |