| NPI | 1598748469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 00012999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WY 5831A) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2013-11-19 |