| NPI | 1609825777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101240896) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D62061) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2016-02-23 |