| NPI | 1578656708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 220780) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 28905) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2012-01-25 |