| NPI | 1629170519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX H5279) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H5279) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2015-08-24 |