| NPI | 1629272117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 201301633) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 45293) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2017-07-26 |